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miR122-controlled all-in-one nanoplatform for in situ theranostic of drug-induced liver injury by visualization imaging guided on-demand drug release. Mater Today Bio 2021; 12:100157. [PMID: 34825161 PMCID: PMC8604687 DOI: 10.1016/j.mtbio.2021.100157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/07/2021] [Accepted: 11/09/2021] [Indexed: 01/10/2023] Open
Abstract
Drug-induced liver injury (DILI) is a challenging clinical problem with respect to both diagnosis and management. As a newly emerging biomarker of liver injury, miR122 shows great potential in early and sensitive in situ detection of DILI. Glycyrrhetinic acid (GA) possesses desirable therapeutic effect on DILI, but its certain dose-dependent side effects after long-term and/or high-dose administration limit its clinical application. In this study, in order to improve the precise diagnosis and effective treatment of DILI, GA loaded all-in-one theranostic nanoplatform was designed by assembling of upconversion nanoparticles and gold nanocages. As a proof of concept, we demonstrated the applicability of this single-wavelength laser-triggered theranostic nanoplatform for the spatiotemporally controllable in situ imaging of DILI and miR122-controlled on-demand drug release in vitro and in vivo. This novel nanoplatform opens a promising avenue for the clinical diagnosis and treatment of DILI.
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Tronina T, Mrozowska M, Bartmańska A, Popłoński J, Sordon S, Huszcza E. Simple and Rapid Method for Wogonin Preparation and Its Biotransformation. Int J Mol Sci 2021; 22:ijms22168973. [PMID: 34445678 PMCID: PMC8396506 DOI: 10.3390/ijms22168973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 11/16/2022] Open
Abstract
Wogonin is one of the most active flavonoids from Scutellaria baicalensis Georgi (baikal skullcap), widely used in traditional Chinese medicine. It exhibits a broad spectrum of health-promoting and therapeutic activities. Together with baicalein, it is considered to be the one of main active ingredients of Chinese medicines for the management of COVID-19. However, therapeutic use of wogonin may be limited due to low market availability connected with its low content in baikal skullcap and lack of efficient preparative methods for obtaining this compound. Although the amount of wogonin in skullcap root often does not exceed 0.5%, this material is rich in wogonin glucuronide, which may be used as a substrate for wogonin production. In the present study, a rapid, simple, cheap and effective method of wogonin and baicalein preparation, which provides gram quantities of both flavonoids, is proposed. The obtained wogonin was used as a substrate for biotransformation. Thirty-six microorganisms were tested in screening studies. The most efficient were used in enlarged scale transformations to determine metabolism of this xenobiotic. The major phase I metabolism product was 4′-hydroxywogonin—a rare flavonoid which exhibits anticancer activity—whereas phase II metabolism products were glucosides of wogonin. The present studies complement and extend the knowledge on the effect of substitution of A- and B-ring on the regioselective glycosylation of flavonoids catalyzed by microorganisms.
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Affiliation(s)
- Tomasz Tronina
- Department of Chemistry, Wrocław University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wrocław, Poland; (A.B.); (J.P.); (S.S.); (E.H.)
- Correspondence: ; Tel.: +48-71320-5019
| | - Monika Mrozowska
- Department of Histology and Embryology, Wroclaw Medical University, T. Chałubinskiego 6a, 50-368 Wroclaw, Poland;
| | - Agnieszka Bartmańska
- Department of Chemistry, Wrocław University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wrocław, Poland; (A.B.); (J.P.); (S.S.); (E.H.)
| | - Jarosław Popłoński
- Department of Chemistry, Wrocław University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wrocław, Poland; (A.B.); (J.P.); (S.S.); (E.H.)
| | - Sandra Sordon
- Department of Chemistry, Wrocław University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wrocław, Poland; (A.B.); (J.P.); (S.S.); (E.H.)
| | - Ewa Huszcza
- Department of Chemistry, Wrocław University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wrocław, Poland; (A.B.); (J.P.); (S.S.); (E.H.)
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Xu W, Zhu H, Hu B, Cheng Y, Guo Y, Yao W, Qian H. Echinacea in hepatopathy: A review of its phytochemistry, pharmacology, and safety. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2021; 87:153572. [PMID: 34029938 DOI: 10.1016/j.phymed.2021.153572] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 04/07/2021] [Accepted: 04/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Echinacea, one of the most popular herbs with double function of immunity and anti-inflammatory activity, has now attracted much interest for a possible alternative for the treatment of hepatopathy. This review is aimed at providing a comprehensive overview of Echinacea regarding its chemical composition, pharmacological action against various hepatopathy, and safety. METHODS A comprehensive search of published articles was conducted to focus on original publications related to Echinacea and hepatopathy till the end of 2020 using various literature databases, including China National Knowledge Infrastructure, PubMed, and Web of Science database. RESULTS Echinacea exhibited excellent activities in resisting a variety of hepatopathy induced by different causes in preclinical experiments and clinical trials by regulating cell proliferation and apoptosis, antioxidant defense mechanism, voltage-gated sodium channels, lipid metabolism, circadian rhythm, p38 MAPK signaling pathway, JNK signaling pathway, Nrf2/HO-1 signaling pathway, PI3K/AKT signaling pathway, and Akt/GSK3 beta signaling pathways. The high efficacy of Echinacea is related to its immunomodulatory and anti-inflammatory activities. The main ingredients of Echinacea include caffeic acid derivatives, alkylamides, and polysaccharides, which have been well established in preclinical studies of liver diseases. Studies on acute and subacute toxicity show that Echinacea preparations are well-tolerated herbal medicines. CONCLUSION Echinacea may offer a novel potential strategy for clinical prevention and treatment of liver diseases and related diseases. Extensive studies are necessary to identify the underlying mechanisms and establish future therapeutic potentials of this herb. Well-designed clinical trials are still warranted to confirm the safety and effectiveness of Echinacea for hepatopathy.
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Affiliation(s)
- Wenqian Xu
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, No. 1800, Lihu Ave, Wuxi, Jiangsu 214122, China; International Joint Laboratory on Food Safety, Jiangnan University, Wuxi 214122, China
| | - Hongkang Zhu
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, No. 1800, Lihu Ave, Wuxi, Jiangsu 214122, China; International Joint Laboratory on Food Safety, Jiangnan University, Wuxi 214122, China
| | - Bin Hu
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, No. 1800, Lihu Ave, Wuxi, Jiangsu 214122, China; International Joint Laboratory on Food Safety, Jiangnan University, Wuxi 214122, China
| | - Yuliang Cheng
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, No. 1800, Lihu Ave, Wuxi, Jiangsu 214122, China; International Joint Laboratory on Food Safety, Jiangnan University, Wuxi 214122, China
| | - Yahui Guo
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, No. 1800, Lihu Ave, Wuxi, Jiangsu 214122, China; International Joint Laboratory on Food Safety, Jiangnan University, Wuxi 214122, China
| | - Weirong Yao
- School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
| | - He Qian
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, No. 1800, Lihu Ave, Wuxi, Jiangsu 214122, China; International Joint Laboratory on Food Safety, Jiangnan University, Wuxi 214122, China.
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Dong PL, Li Z, Teng CL, Yin X, Cao XK, Han H. Synthesis and evolution of neuroprotective effects of oxymatrine derivatives as anti-Alzheimer's disease agents. Chem Biol Drug Des 2021; 98:175-181. [PMID: 33963669 DOI: 10.1111/cbdd.13862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/03/2021] [Accepted: 03/14/2021] [Indexed: 12/01/2022]
Abstract
While screening for natural product scaffolds as potential anti-Alzheimer's disease (AD), oxymatrine (OMT) was found to relieve symptoms of AD through diminishing death of neuronal cells caused by microglia-induced inflammation. In this study, 13 derivatives of OMT were synthesized and their neuroprotective effects were evaluated on Aβ1-42 -induced PC12 cells using MTT method. In addition, the best neuroprotective potencies were obtained with compounds 4, 6e, and 6f, which were selected for evaluation of decrease in IL-1β and TNF-α in Aβ1-42 -treated PC12 cells. Collectively, these data reveal that derivatives 6e and 6f possess the best ability of diminish IL-1β production and reverse cell damage in all compounds, which are possible to develop as therapeutic agents for AD.
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Affiliation(s)
- Pei-Liang Dong
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - ZhengQing Li
- Institute of Chinese Medical Sciences and State Key Laboratory of Quality Research in Chinese Medicine, University of Macau, Taipa, China
| | | | - Xin Yin
- Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Xian-Kai Cao
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Hua Han
- Heilongjiang University of Chinese Medicine, Harbin, China
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Sultana B, Yaqoob S, Zafar Z, Bhatti HN. Escalation of liver malfunctioning: A step toward Herbal Awareness. JOURNAL OF ETHNOPHARMACOLOGY 2018; 216:104-119. [PMID: 29309862 DOI: 10.1016/j.jep.2018.01.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 01/03/2018] [Accepted: 01/03/2018] [Indexed: 06/07/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE About 2-5% of the world's population is suffering from liver toxicity including Pakistan with the second highest rate of hepatitis prevalence. Liver is a vital body organ which not only performs metabolic activities but also aids in detoxification, storage and digestion of food. Now a day's malnutrition, alcohol consumption and drug addiction are major causes of liver diseases throughout the world. In fact, there is no possible outcome to compensate liver malfunction for long term, and transplantation of liver is the only option left after the irretrievable injury of hepatic function. Subsequently, natural based therapeutic approaches are in the process of scrupulous testing as strong hepatoprotective mediator. In this regard plants are well thought hepatoprotective agents having multiple active components. In this review, based on species' pharmacology and safety we have compiled some plants which show strong hepatoprotective activity, main phytoconstituents with biological activities and few commercially used herbal formulations. MATERIALS AND METHODS Ethnopharmacological information was gathered by an extensive literature survey like WHO monographs on selected herbal medicinal plants (Vol 1-Vol 4); Principles and Practice of Phytotherapy, Mills S and Bone K, Churchill Livingstone, London, UK; Herbal Drugs and Phytopharmaceuticals, Wichtl M Medpharm Press, Stuttgart 3rd edn; Pharmacology and Applications of Chinese Materia Medica Vols 1 and 2, Chang H-M and But P P-H World Scientific, Singapore; British Herbal Compendium Vol. 2, Bradley P British Herbal Medicine Association, Bournemouth, UK; ESCOP Monographs 2nd edn. Thieme, Stuttgart, Germany; as well as by using electronic databases such as Pubchem, Chemspider, http://www.herbal-ahp.org; http://www.ahpa.org; http://whqlibdoc.who.int/publications/2003/9241546271.pdf; http://www.escop.com, Pubmed, HubMed and Scopus. RESULTS Data for more about 29 plants have been accomplished for their bioactive constituent(s), biological activities and medicinal uses. Some of the plants have been identified as strong hepato-modulator. Such knowledge about traditional medicinal plants can be globally applied for safe and evidence based use in pharmacological applications. CONCLUSION With the rise in liver risks a meek struggle has been made to draw attention toward herbal therapy. Hepatoprotective constituents of said plants are expressed with chemical structures. However, for certain plants active constituents are not still isolated/purified but overall plant extract was found effective in providing protection against hepatic injury. As a future perspective, there is need to purify plant active constituents for ethnomedical rationale.
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Affiliation(s)
- Bushra Sultana
- Department of Chemistry, University of Agriculture, Faisalabad, Pakistan.
| | - Sadaf Yaqoob
- Department of Chemistry, University of Agriculture, Faisalabad, Pakistan.
| | - Zohaib Zafar
- Department of Chemistry, University of Agriculture, Faisalabad, Pakistan.
| | - Haq Nawaz Bhatti
- Department of Chemistry, University of Agriculture, Faisalabad, Pakistan.
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Comparison of glycyrrhizin content in 25 major kinds of Kampo extracts containing Glycyrrhizae Radix used clinically in Japan. J Nat Med 2017; 71:711-722. [PMID: 28608269 PMCID: PMC5897458 DOI: 10.1007/s11418-017-1101-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 06/02/2017] [Indexed: 11/06/2022]
Abstract
Glycyrrhizae Radix is the most frequently used crude drug in Japan and is prescribed in Kampo medicine for the treatment of a wide range of diseases. The major active ingredient of Glycyrrhizae Radix, glycyrrhizin (GL), has been shown to possess various pharmacological actions, but is also known to cause adverse effects such as pseudoaldosteronism. To avoid the adverse effects of GL, precautions have been indicated on the package inserts of Glycyrrhizae Radix-containing formulas depending on the amount of Glycyrrhizae Radix they contain. However, it remains unknown whether the extraction efficiency of GL from Glycyrrhizae Radix is constant throughout the different combinations of crude drugs in Glycyrrhizae Radix-containing formulas. To confirm the basis of the safety regulation, in this study we comprehensively determined the GL content of 25 major kinds of Kampo extracts compounding Glycyrrhizae Radix. We found that the GL content per daily dosage in all Kampo extracts are generally proportional to the compounding amount of Glycyrrhizae Radix, except in the case of shoseiryuto (Sho-seiryu-To). We also found that Schisandrae Fructus in Sho-seiryu-To decoction caused a lowered pH condition and drastically decreased the extraction efficacy of GL from Glycyrrhizae Radix. Moreover, we were able to confirm that the extraction efficiency of GL from Glycyrrhizae Radix is dependent on the pH value of the extraction solvent. The extraction efficiency of GL in the 25 kinds of Kampo extracts was not constant but it correlates significantly with the pH value of the decoction. Furthermore, the GL contents are well correlated with pseudoaldosteronism incidence data obtained from the Japanese Adverse Drug Event Report (JADER) database on the 25 kinds of Kampo extracts. This suggests that the GL content is a better index to consider to avoid the adverse effects of Glycyrrhizae Radix-containing Kampo formulas.
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Waki K, Yamada A. Blockade of high mobility group box 1 augments antitumor T-cell response induced by peptide vaccination as a co-adjuvant. Cancer Sci 2016; 107:1721-1729. [PMID: 27717108 PMCID: PMC5198958 DOI: 10.1111/cas.13084] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/15/2016] [Accepted: 09/19/2016] [Indexed: 02/06/2023] Open
Abstract
High mobility group box 1 (HMGB1) is a member of the family of damage-associated molecular patterns, which cause inflammation and trigger innate immunity through Toll-like receptors 2/4 and the receptor for advanced glycation end products. We examined the effect of glycyrrhizin, a selective inhibitor of HMGB1, on the induction of CTLs in mice. B6 mice, either OT-1 spleen cell-transferred or untransferred, were immunized with an s.c. injection of OVA257-264 peptide with topical imiquimod, and glycyrrhizin was mixed with the antigen peptide. Proliferation of OT-1 cells after immunization was enhanced by glycyrrhizin. The effect of glycyrrhizin was confirmed in other adjuvant systems, such as CpG oligonucleotide and monophosphoryl lipid A, but glycyrrhizin was not effective in Freund's incomplete adjuvant system. The augmenting effects of glycyrrhizin were also observed in other synthetic HMGB1 inhibitors, gabexate mesilate, nafamostat, and sivelestat. Thus, the effects are common to the HMGB1 inhibitors. Induction of CTLs detected by γ-interferon enzyme-linked immunospot assay was similarly augmented by glycyrrhizin. In a therapeutic vaccine model, glycyrrhizin inhibited the growth of s.c. transplanted EG.7 tumors. Expression of inflammatory cytokines in the skin inoculation site was downregulated by glycyrrhizin. These results suggest that HMGB1 inhibitors might be useful as a co-adjuvant for peptide vaccination with an innate immunity receptor-related adjuvant.
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Affiliation(s)
- Kayoko Waki
- Cancer Vaccine Development Division, Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Japan
| | - Akira Yamada
- Cancer Vaccine Development Division, Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Japan
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Liu CY, Ko PH, Yen HR, Cheng CH, Li YH, Liao ZH, Hsu CH. The Chinese medicine Kuan-Sin-Yin improves liver function in patients with chronic hepatitis C: A randomised and placebo-controlled trial. Complement Ther Med 2016; 27:114-22. [PMID: 27515885 DOI: 10.1016/j.ctim.2016.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 05/30/2016] [Accepted: 06/11/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND & AIMS This study examined the effects of a traditional Chinese medicine decoction, Kuan-Sin-Yin (KSY), on patients with chronic hepatitis C (CHC) in a randomised and placebo-controlled clinical trial. METHODS This trial enrolled 70 subjects with CHC who were randomised into 2 groups each with 35 participants. In total, 29 participants in the therapeutic group took 100mL of the herbal decoction daily, whereas 28 in the control group took an herbal placebo with the same dose and frequency for the 6-week study. The primary outcomes were liver function and viral load. Secondary measurements included haematopoietic and biochemical profiles, safety parameters, and a quality of life survey. All measurements were collected at the beginning of the study and after 6 weeks. RESULTS In within-group analysis, significant decreases of glutamate pyruvate transaminase (GPT) 31.7±75.2IU/L and glutamate oxaloacetate transaminase (GOT) 20.3±45.7IU/L were found in the KSY group (p=0.031 and 0.024, respectively). In the between-group analysis, KSY reduced serum GOT and GPT levels by more than 20IU/L (p=0.027 and 0.047, respectively). KSY also significantly decreased viral load by 0.3 log units (p=0.047). In addition, KSY significantly decreased serum triglyceride 16.9±27.5mg/dL (p=0.024). CONCLUSIONS This study demonstrates that taking the KSY herbal decoction for 6 weeks improves liver function and serum triglyceride levels and is safe for patients with CHC. The potential long-term effects of KSY on lipid metabolism related hepatoprotection and viral clearance warrant further investigation.
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Affiliation(s)
- Chia-Yu Liu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Chinese Medicine, Branch of Linsen and Chinese Medicine, Taipei City Hospital, Taipei, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Pin-Hao Ko
- Graduate Institute of Physiology, National Taiwan University, Taipei, Taiwan
| | - Hung-Rong Yen
- School of Chinese Medicine, China Medical University, Taichung, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan; Research Center for Traditional Chinese Medicine, Department of Medical Research, and Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chen-Hung Cheng
- Department of Chinese Medicine, Branch of Linsen and Chinese Medicine, Taipei City Hospital, Taipei, Taiwan
| | - Yu-Hsien Li
- Department of Gastroenterology, Branch of Linsen and Chinese Medicine, Taipei City Hospital, Taipei, Taiwan
| | - Zih-Han Liao
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chung-Hua Hsu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Chinese Medicine, Branch of Linsen and Chinese Medicine, Taipei City Hospital, Taipei, Taiwan; School of Chinese Medicine, China Medical University, Taichung, Taiwan.
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Kristanc L, Kreft S. European medicinal and edible plants associated with subacute and chronic toxicity part I: Plants with carcinogenic, teratogenic and endocrine-disrupting effects. Food Chem Toxicol 2016; 92:150-64. [PMID: 27090581 DOI: 10.1016/j.fct.2016.04.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 04/08/2016] [Accepted: 04/10/2016] [Indexed: 12/14/2022]
Abstract
In recent decades, the use of herbal medicines and food products has been widely embraced in many developed countries. These products are generally highly accepted by consumers who often believe that "natural" equals "safe". This is, however, an oversimplification because several botanicals have been found to contain toxic compounds in concentrations harmful to human health. Acutely toxic plants are in most cases already recognised as dangerous as a result of their traditional use, but plants with subacute and chronic toxicity are difficult or even impossible to detect by traditional use or by clinical research studies. In this review, we systematically address major issues including the carcinogenicity, teratogenicity and endocrine-disrupting effects associated with the use of herbal preparations with a strong focus on plant species that either grow natively or are cultivated in Europe. The basic information regarding the molecular mechanisms of the individual subtypes of plant-induced non-acute toxicity is given, which is followed by a discussion of the pathophysiological and clinical characteristics. We describe the genotoxic and carcinogenic effects of alkenylbenzenes, pyrrolizidine alkaloids and bracken fern ptaquiloside, the teratogenicity issues regarding anthraquinone glycosides and specific alkaloids, and discuss the human health concerns regarding the phytoestrogens and licorice consumption in detail.
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Affiliation(s)
- Luka Kristanc
- Institute of Biophysics, Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia; Primary Healthcare of Gorenjska, ZD Kranj, Gosposvetska Ulica 10, 4000 Kranj, Slovenia.
| | - Samo Kreft
- Faculty of Pharmacy, University of Ljubljana, Tržaška Cesta 32, 1000 Ljubljana, Slovenia
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Rehan HS, Chopra D, Yadav M, Wardhan N, Manak S, Siddiqui KM, Aslam M. Safety and efficacy of Qurse-e-istisqua in chronic hepatitis C infection: an exploratory study. Indian J Pharmacol 2015; 47:72-9. [PMID: 25821315 PMCID: PMC4375823 DOI: 10.4103/0253-7613.150347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 11/24/2014] [Accepted: 12/30/2014] [Indexed: 12/02/2022] Open
Abstract
Background: Qurse-e-istisqua (Q-e-I), an Unani medicine commonly prescribed to treat liver disorders. Objectives: To study efficacy and safety of Q-e-I in hepatitis C virus (HCV) infection. Methods: In this randomized double-blind exploratory study, 60 naive patients of HCV infection were assigned to receive either interferonα2a (IFNα2a) (3 mIU, subcutaneous, thrice weekly), ribavirin (RBV) (1000 mg, orally, twice daily in divided doses) and placebo (n = 30) or IFNα2a, RBV and Q-e-I (5 g, orally, thrice daily in divided doses) (n = 30). HCV RNA levels, serum hyaluronic acid (SHA), ultrasound image scoring for fibrosis, liver and renal function test, prothrombin time, were done at the baseline and thereafter periodically. Results: Early virologic response (EVR), end of treatment response (ETR) and sustained virologic response (SVR) were 90%, 96.6% and 90% in the control group and 86.6%, 90.0% and 83.3% in the treatment group. SHA level was lower in the treatment group at the end of the treatment as compared to the control group. Mean end of follow-up ultrasound image scoring for fibrosis in the control and the treatment group was 1.37 ± 0.07 and 1.22 ± 0.06 respectively. Aspartate aminotransferase (AST) levels were significantly lower in the treatment group than the control group at 1-month. Commonly observed adverse drug reactions included fever, hair fall, fatigue, anemia, and diarrhea. Conclusion: Q-e-I was well tolerated and showed anti-fibrotic activity. EVR, ETR and SVR suggested that Q-e-I do not have any anti-HCV activity. Early recovery in AST and inhibition of progress of fibrosis in Q-e-I group was probably due to the anti-inflammatory and antioxidant activity of its ingredients.
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Affiliation(s)
| | - Deepti Chopra
- Department of Pharmacology, HIMSR, Jamia Hamdard, New Delhi, India
| | - Madhur Yadav
- Department of Medicine, Lady Hardinge Medical College, New Delhi, India
| | - Neeta Wardhan
- Department of Pharmacology, University College of Medical Sciences, New Delhi, India
| | - Seema Manak
- Department of Pharmacology, Lady Hardinge Medical College, New Delhi, India
| | - K M Siddiqui
- Central Council for Research in Unani Medicines, AYUSH, Ministry of Health and Family Welfare, Janak Puri, New Delhi, India
| | - Mohd Aslam
- Department Pharmacology Ilmul Advia, faculty of Unani Medicine, Hamdard University, New Delhi, India
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Imai K, Beppu T, Yamao T, Okabe H, Hayashi H, Nitta H, Hashimoto D, Mima K, Nakagawa S, Sakamoto K, Chikamoto A, Ishiko T, Baba H. Clinicopathological and prognostic significance of preoperative serum zinc status in patients with hepatocellular carcinoma after initial hepatectomy. Ann Surg Oncol 2014; 21:3817-26. [PMID: 24841354 DOI: 10.1245/s10434-014-3786-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND The purpose of this study was to determine the relationship between serum zinc (Zn) level and clinicopathological profiles in patients with hepatocellular carcinoma (HCC). Furthermore, we investigate the influence of serum Zn level on the long-term prognosis after hepatectomy. METHODS A retrospective analysis was conducted of 310 patients who underwent initial hepatectomy for HCC. The correlation between serum Zn level and preoperative liver functional indicator, pathological features, including the degree of hepatic fibrosis, and perioperative outcome were evaluated. The patients were divided into two groups (serum Zn ≤ 65 mg/dL; n = 71 and Zn > 65 mg/dL; n = 239), and their long-term prognosis were compared. RESULTS There were strong correlations between preoperative serum Zn level and serum albumin (r = 0.47, P < 0.0001), branched-chain amino acids (r = 0.28, P < 0.0001), and hyaluronic acid level (r = -0.33, P < 0.0001). The patients with low Zn group were characterized as hepatitis C virus (HCV) infection, impaired liver function, background hepatic fibrosis, and pathological vascular invasion. The disease-free and overall survivals in the low Zn group were significantly lower than those in the high Zn group, especially in subgroup with HCV-related liver disease (P = 0.041 and 0.0004, respectively). Multivariate analyses showed that serum Zn level was an independent prognostic factor for overall survival (hazard ratio 1.79, P = 0.038). CONCLUSIONS Serum Zn level reflects liver function and is useful for predicting the hepatic fibrosis before surgery. The prognosis of patients with HCC was found to be associated with preoperative serum Zn level, especially in patients with HCV-related chronic liver disease.
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Affiliation(s)
- Katsunori Imai
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, 860-8556, Kumamoto, Japan
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Complementary and alternative medicine use by patients visiting a free health clinic: A single-site, pilot study. Curr Ther Res Clin Exp 2014; 65:481-94. [PMID: 24672100 DOI: 10.1016/j.curtheres.2005.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2004] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The rate of use of complementary and alternative medicine (CAM) has been documented to fluctuate widely, can greatly impact medical outcomes, and can influence patients' adherence to conventional medicines. Health care providers should assess the prevalence of CAM use (primarily herbal medicine) in individual settings to most accurately provide appropriate patient care. OBJECTIVES THE AIM OF THIS STUDY WAS TO DETERMINE THE FOLLOWING: (1) differences in demographic characteristics between users and nonusers of CAM; (2) which CAM patients are using; (3) patients' sources of information concerning CAM; and (4) whether patients recall being asked about CAM use by their health care providers. METHODS In this single-center, pilot study, a self-administered survey concerning CAM use was made available to persons seeking care at an inner-city free health clinic (Kansas City Free Health Clinic, Kansas City, Missouri). Completed surveys were scanned into a database, and descriptive analyses were performed. RESULTS Three hundred eleven patients completed ≥1 question on the survey. Of those who reported race (n = 278), 168 (60.4%) were Caucasian/white, 73 (26.3%) were African American/black, and 24 (8.6%) were Hispanic/Latino. Of those who reported educational level (n = 287), 101 (35.2%) had some high school or were high school graduates or had a general equivalency development diploma, 102 (35.5%) had completed some college or vocational training, and 84 (29.3%) had completed college. Of those who reported personal annual income (n = 191), 107 (56.0%) reported up to US $15,000, and 54 (28.3%) reported >$15,000 to $30,000. A high rate of CAM use (past or present) was found among survey respondents (116/285 [40.7%]). No correlation was found between CAM use and any of the demographic characteristics studied. Of 98 patients reporting whether their CAM use was past or current, 64 (65.3%) were using CAM at the time of the survey. Friends and physicians were reported to be most supportive of CAM use (21/41 [51.2%] and 33/86 [38.4%] patients, respectively). The most common CAM products reported as being currently used were garlic and chamomile (both, 5 patients [7.1%]), and echinacea and ginseng (both, 3 patients [4.7%]). CONCLUSION This survey of patients using an inner-city free health clinic showed a high rate of CAM use, which could significantly impact patient outcomes.
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Marzio DLHD, Fenkel JM. Complementary and alternative medications in hepatitis C infection. World J Hepatol 2014; 6:9-16. [PMID: 24653790 PMCID: PMC3953807 DOI: 10.4254/wjh.v6.i1.9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 12/22/2013] [Accepted: 01/06/2014] [Indexed: 02/06/2023] Open
Abstract
Chronic hepatitis C (CHC) infection affects almost 3% of the global population and can lead to cirrhosis, liver failure, and hepatocellular carcinoma in a significant number of those infected. Until recently, the only treatments available were pegylated interferon and ribavirin, which traditionally were not very effective and have considerable side effects. For this reason, interest in complementary and alternative medications (CAM) in the management of hepatitis C has been investigated. Some CAM has demonstrated therapeutic potential in chronic hepatitis C treatment. Unfortunately, some CAM has been shown to have the potential to cause drug-induced liver injury. This article will review and evaluate many of the natural molecules that interact with the hepatitis C virus (HCV) life cycle and discuss their potential use and safety in HCV therapy, as well as highlight some important interactions between medical and complementary treatments.
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Affiliation(s)
- Dina L Halegoua-De Marzio
- Dina L Halegoua-De Marzio, Jonathan M Fenkel, Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, United States
| | - Jonathan M Fenkel
- Dina L Halegoua-De Marzio, Jonathan M Fenkel, Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, United States
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Dikusar EA, Potkin VI, Kozlov NG, Gadzhily RA, Tlegenov RT, Yuvchenko AP, Zheldakova RA. Synthesis and study of the fungicidal activity of amine salts of glycyrrhizic acid. RUSSIAN JOURNAL OF BIOORGANIC CHEMISTRY 2012. [DOI: 10.1134/s1068162012070047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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15
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Herbal products: benefits, limits, and applications in chronic liver disease. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:837939. [PMID: 22991573 PMCID: PMC3443820 DOI: 10.1155/2012/837939] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 07/30/2012] [Indexed: 12/14/2022]
Abstract
Complementary and alternative medicine soughts and encompasses a wide range of approaches; its use begun in ancient China at the time of Xia dynasty and in India during the Vedic period, but thanks to its long-lasting curative effect, easy availability, natural way of healing, and poor side-effects it is gaining importance throughout the world in clinical practice. We conducted a review describing the effects and the limits of using herbal products in chronic liver disease, focusing our attention on those most known, such as quercetin or curcumin. We tried to describe their pharmacokinetics, biological properties, and their beneficial effects (as antioxidant role) in metabolic, alcoholic, and viral hepatitis (considering that oxidative stress is the common pathway of chronic liver diseases of different etiology). The main limit of applicability of CAM comes from the lacking of randomized, placebo-controlled clinical trials giving a real proof of efficacy of those products, so that anecdotal success and personal experience are frequently the driving force for acceptance of CAM in the population.
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Zhao MX, Ji LN, Mao ZW. β-Cyclodextrin/glycyrrhizic acid functionalised quantum dots selectively enter hepatic cells and induce apoptosis. Chemistry 2012; 18:1650-8. [PMID: 22213427 DOI: 10.1002/chem.201102795] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Indexed: 02/02/2023]
Abstract
The use of active components from important medical herbs has proved effective in treating various cancers. Glycyrrhizic acid (GA) is one of the many interesting triterpenoic acids with anticancerogenic potential, and is known to trigger apoptosis in hepatocarcinoma cells. In this study we combined quantum dots (QDs) with GA in the presence of β-cyclodextrin (β-CD), and prepared β-CD/GA-functionalised QDs, which led to improved antitumor activity and induced apoptosis in hepatocarcinoma cells. These compounds showed a better selectivity for hepatic cells compared to HeLa and ECV-304 cells. Hoechst and annexin V-FITC staining and mitochondrial membrane potential (MMP) experiments proved an apoptotic effect of these compounds on HepG2 cells. At the same time, transmission electron microscopy (TEM) showed obvious features of apoptosis, for example, irregularities of nuclear shapes, mitochondria swelling, clumping and peripheral chromatin condensation, zeiosis or blebbing of the plasma membrane and formation of apoptotic bodies. It is notable that β-CD/GA-functionalised QDs showed effective cell growth inhibition by triggering G0/G1 phase arrest and inducing apoptosis through an reactive oxygen species mediated mitochondrial dysfunction pathway. β-CD/GA-functionalised QDs primarily induced apoptotic response in a time- and dose-dependent manner, but little apoptosis appeared with L-Cys-β-CD-functionalised QDs or GA alone. These studies suggest that β-CD/GA-functionalised QDs have therapeutic potential against cancer.
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Affiliation(s)
- Mei-Xia Zhao
- MOE Key Laboratory of Bioinorganic and Synthetic Chemistry, School of Chemistry and Chemical Engineering, Sun Yat-Sen University, Guangzhou 510275, P.R. China
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Diversity of Pharmacological Properties in Chinese and European Medicinal Plants: Cytotoxicity, Antiviral and Antitrypanosomal Screening of 82 Herbal Drugs. DIVERSITY-BASEL 2011. [DOI: 10.3390/d3040547] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Cherng JM, Tsai KD, Yu YW, Lin JC. Molecular Mechanisms Underlying Chemopreventive Activities of Glycyrrhizic Acid against UVB-Radiation-Induced Carcinogenesis in SKH-1 Hairless Mouse Epidermis. Radiat Res 2011; 176:177-86. [DOI: 10.1667/rr2510.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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19
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Marshall G, Sykes AE. Systematic reviews: A guide for radiographers and other health care professionals. Radiography (Lond) 2011. [DOI: 10.1016/j.radi.2010.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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20
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Wang YJ, Pan KL, Hsieh TC, Chang TY, Lin WH, Hsu JTA. Diosgenin, a plant-derived sapogenin, exhibits antiviral activity in vitro against hepatitis C virus. JOURNAL OF NATURAL PRODUCTS 2011; 74:580-4. [PMID: 21391660 DOI: 10.1021/np100578u] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Diosgenin (3β-hydroxy-5-spirostene, 1), a plant-derived sapogenin, is used as a dietary supplement. However, the biological effects of 1 related to viral replication remain unexplored. In this study, the effects of 1 on hepatitis C virus (HCV) replication were evaluated. Based on a reporter-based HCV subgenomic replicon system, 1 was found to inhibit HCV replication at low micromolar concentrations. The EC(50) (concentration at which 50% of HCV replication is inhibited) of 1 was 3.8 μM. No cellular toxicity was observed at this concentration. Diosgenin (1) also significantly reduced the levels of viral RNA and viral proteins as evaluated by quantitative real-time reverse transcriptase PCR and Western blot analysis, respectively. In addition, in an alternative HCV antiviral system more closely aligned to all steps involved in the HCV infection and life cycle, 1 totally abolished HCV replication at 20 μM. Moreover, 1 reduced the phosphorylation of signal transducer and activator of transcription 3. A combination of 1 and interferon-α exerted an additive effect on the resultant anti-HCV activity.
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Affiliation(s)
- Ya-Jean Wang
- Division of Biotechnology and Pharmaceutical Research, National Health Research Institutes, Zhunan, Taiwan, Republic of China
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21
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Effect and mechanism of penetration enhancement of organic base and alcohol on Glycyrrhetinic acid in vitro. Int J Pharm 2010; 399:102-8. [DOI: 10.1016/j.ijpharm.2010.08.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2010] [Revised: 07/03/2010] [Accepted: 08/07/2010] [Indexed: 11/21/2022]
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Li J, Yu H, Li S, Wang GJ. Enhanced distribution and extended elimination of glycyrrhetinic acid in mice liver by mPEG-PLA modified (mPEGylated) liposome. J Pharm Biomed Anal 2010; 51:1147-53. [DOI: 10.1016/j.jpba.2009.11.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2009] [Revised: 10/31/2009] [Accepted: 11/08/2009] [Indexed: 11/24/2022]
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Baltina LA, Kondratenko RM, Baltina LA, Plyasunova OA, Pokrovskii AG, Tolstikov GA. Prospects for the creation of new antiviral drugs based on glycyrrhizic acid and its derivatives (a review). Pharm Chem J 2010; 43:539-548. [PMID: 32214533 PMCID: PMC7089237 DOI: 10.1007/s11094-010-0348-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2006] [Indexed: 11/23/2022]
Abstract
The review is devoted to the problem of creating new antiviral drugs based on glycyrrhizic acid (GA), the major triterpene glycoside extracted from roots of common and Ural licorice (Glycyrrhiza glabra L. and G. uralensis Fisher, respectively). Published data on the natural GA sources, antiviral activity of GA and its derivatives, clinical applications of GA-based drugs, and the properties of GA-containing biologically active nutrient additives are summarized. Possible mechanisms of the antiviral activity of GA and its derivatives are examined. It is shown that chemical modification of GA is a promising way of designing new highly active antiviral drugs for the prophylaxis and treatment of HIV, hepatitis B and C, corona-virus, and herpes simplex virus infections.
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Affiliation(s)
- L. A. Baltina
- Institute of Organic Chemistry, UfaScientific Center, Russian Academy of Sciences, Ufa, Bashkortostan Russia
| | | | - L. A. Baltina
- Institute of Organic Chemistry, UfaScientific Center, Russian Academy of Sciences, Ufa, Bashkortostan Russia
| | - O. A. Plyasunova
- State Research Center of Virology and Biotechnology Vector, Kol’tsovo, Novosibirsk Oblast Russia
| | - A. G. Pokrovskii
- State Research Center of Virology and Biotechnology Vector, Kol’tsovo, Novosibirsk Oblast Russia
| | - G. A. Tolstikov
- Institute of Organic Chemistry, UfaScientific Center, Russian Academy of Sciences, Ufa, Bashkortostan Russia
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Nakamura M, Saito H, Ikeda M, Hokari R, Kato N, Hibi T, Miura S. An antioxidant resveratrol significantly enhanced replication of hepatitis C virus. World J Gastroenterol 2010; 16:184-92. [PMID: 20066737 PMCID: PMC2806556 DOI: 10.3748/wjg.v16.i2.184] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To elucidate the effect of antioxidants, resveratrol (RVT) and astaxanthin (AXN), on hepatitis C virus (HCV) replication.
METHODS: We investigated the effect of recent popular antioxidant supplements on replication of the HCV replicon system OR6. RVT is a strong antioxidant and a kind of polyphenol that inhibits replication of various viruses. AXN is also a strong antioxidant. The replication of HCV RNA was assessed by the luciferase reporter assay. An additive effect of antioxidants on antiviral effects of interferon (IFN) and ribavirin (RBV) was investigated.
RESULTS: This is the first report to investigate the effect of RVT and AXN on HCV replication. In contrast to other reported viruses, RVT significantly enhanced HCV RNA replication. Vitamin E also enhanced HCV RNA replication as reported previously, although AXN didnot affect replication. IFN and RBV significantly reduced HCV RNA replication, but these effects were dose-dependently hampered and attenuated by the addition of RVT. AXN didnot affect antiviral effects of IFN or RBV.
CONCLUSION: These results suggested that RVT is not suitable as an antioxidant therapy for chronic hepatitis C.
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Matsuoka S, Matsumura H, Nakamura H, Oshiro S, Arakawa Y, Hayashi J, Sekine N, Nirei K, Yamagami H, Ogawa M, Nakajima N, Amaki S, Tanaka N, Moriyama M. Zinc supplementation improves the outcome of chronic hepatitis C and liver cirrhosis. J Clin Biochem Nutr 2009; 45:292-303. [PMID: 19902019 PMCID: PMC2771250 DOI: 10.3164/jcbn.08-246] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2008] [Accepted: 04/28/2009] [Indexed: 11/22/2022] Open
Abstract
We treated patients with C-viral chronic hepatitis (CH) and liver cirrhosis (LC) with polaprezinc and determined prospectively the effect on long-term outcome. 62 patients were enrolled. Of these, 32 were administered 1.0 g polaprezinc and the remainder were not administered polaprezinc. We measured the serum zinc concentrations using conventional atomic absorption spectrometry and conducted a prospective study to determine the long-term outcome of the polaprezinc therapy. Changes of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in the polaprezinc administration group were significantly lower than those of the untreated group. The decrease in platelet count was clearly less than that of the untreated group. The factors that inhibited increases in serum zinc concentrations following administration of polaprezinc included low serum zinc concentration states. Furthermore, the reductions of AST and ALT levels in the low zinc group were significantly greater than those of the high zinc group. When the patients who were administered polaprezinc were divided into two groups whose zinc concentrations increased (zinc responders) or remained stable or decreased (zinc non-responders), the zinc responders had a clearly lower cumulative incidence of HCC than the zinc non-responders. We conclude zinc supplementation improved the long-term outcome in C-viral CH and LC patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Mitsuhiko Moriyama
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1, oyaguchi kamimachi, Itabashiku, Tokyo 173-8610, Japan
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Matsuoka S, Matsumura H, Nakamura H, Oshiro S, Arakawa Y, Hayashi J, Sekine N, Nirei K, Yamagami H, Ogawa M, Nakajima N, Amaki S, Tanaka N, Moriyama M. Zinc supplementation improves the outcome of chronic hepatitis C and liver cirrhosis. J Clin Biochem Nutr 2009. [PMID: 19902019 DOI: 10.3164/jcbn.jcbn08-246] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
We treated patients with C-viral chronic hepatitis (CH) and liver cirrhosis (LC) with polaprezinc and determined prospectively the effect on long-term outcome. 62 patients were enrolled. Of these, 32 were administered 1.0 g polaprezinc and the remainder were not administered polaprezinc. We measured the serum zinc concentrations using conventional atomic absorption spectrometry and conducted a prospective study to determine the long-term outcome of the polaprezinc therapy. Changes of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in the polaprezinc administration group were significantly lower than those of the untreated group. The decrease in platelet count was clearly less than that of the untreated group. The factors that inhibited increases in serum zinc concentrations following administration of polaprezinc included low serum zinc concentration states. Furthermore, the reductions of AST and ALT levels in the low zinc group were significantly greater than those of the high zinc group. When the patients who were administered polaprezinc were divided into two groups whose zinc concentrations increased (zinc responders) or remained stable or decreased (zinc non-responders), the zinc responders had a clearly lower cumulative incidence of HCC than the zinc non-responders. We conclude zinc supplementation improved the long-term outcome in C-viral CH and LC patients.
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Affiliation(s)
- Shunichi Matsuoka
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1, oyaguchi kamimachi, Itabashiku, Tokyo 173-8610, Japan
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Błach-Olszewska Z, Jatczak B, Rak A, Lorenc M, Gulanowski B, Drobna A, Lamer-Zarawska E. Production of cytokines and stimulation of resistance to viral infection in human leukocytes by Scutellaria baicalensis flavones. J Interferon Cytokine Res 2009; 28:571-81. [PMID: 18771341 DOI: 10.1089/jir.2008.0125] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Extracts of Scutellaria baicalensis display a wide spectrum of antiviral activity. It was of great interest to check the effect of baicalein and wogonin preparations on two important mechanisms of innate immunity: the secretion of cytokines and the natural resistance of human leukocytes to viral infection. To study the effect of S. baicalensis extracts on interferons (IFNs), tumor necrosis factor alpha (TNF-alpha), and interleukin (IL) production and virus replication, uninfected and vesicular stomatitis virus (VSV)-infected human peripheral blood leukocytes (PBLs) were used. Four pulverized preparations obtained from roots of Scutellaria and a Sigma-Aldrich preparation of purified baicalein were used in the study. RPMI extracts containing different amounts of baicalein and wogonin were used to study the effect on VSV replication in PBLs. PBLs express ex vivo individually differentiated cytokine-dependent resistance/innate immunity to viral infections. The degree of resistance was estimated on the basis of VSV replication in PBLs. The results obtained indicate that baicalein- and wogonin-containing extracts modulate cytokine production, that is inhibit IFN-alpha and IFN-gamma and stimulate TNF-alpha and IL (IL-12, IL-10) production. They also augment the resistance of PBLs to VSV. Extract from S. baicalensis containing baicalein and wogonin regulates the innate antiviral immunity by modulation of cytokine production and stimulation of human leukocyte resistance.
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Affiliation(s)
- Zofia Błach-Olszewska
- Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland. itd.pan.wroc.pl
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Ruehl M, Erben U, Kim K, Freise C, Dagdelen T, Eisele S, Trowitzsch-Kienast W, Zeitz M, Jia J, Stickel F, Somasundaram R. Extracts of Lindera obtusiloba induce antifibrotic effects in hepatic stellate cells via suppression of a TGF-beta-mediated profibrotic gene expression pattern. J Nutr Biochem 2008; 20:597-606. [PMID: 18824344 DOI: 10.1016/j.jnutbio.2008.06.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Revised: 05/27/2008] [Accepted: 06/05/2008] [Indexed: 01/14/2023]
Abstract
Liver fibrosis is characterized by high expression of the key profibrogenic cytokine transforming growth factor (TGF)-beta and the natural tissue inhibitor of metalloproteinases (TIMP)-1, leading to substantial accumulation of extracellular matrix. Liver fibrosis originates from various chronic liver diseases, such as chronic viral hepatitis that, to date, cannot be treated sufficiently. Thus, novel therapeutics, for example, those derived from Oriental medicine, have gained growing attention. In Korea, extracts prepared from Lindera obtusiloba are used for centuries for treatment of inflammation, improvement of blood circulation and prevention of liver damage, but experimental evidence of their efficacy is lacking. We studied direct antifibrotic effects in activated hepatic stellate cells (HSCs), the main target cell in the fibrotic liver. L. obtusiloba extract (135 mug/ml) reduced the de novo DNA synthesis of activated rat and human HSCs by about 90%, which was not accompanied by cytotoxicity of HSC, primary hepatocytes and HepG2 cells, pointing to induction of cellular quiescence. As determined by quantitative polymerase chain reaction, simultaneous treatment of HSCs with TGF-beta and L. obtusiloba extract resulted in reduction of TIMP-1 expression to baseline level, disruption of the autocrine loop of TGF-beta autoinduction and increased expression of fibrolytic matrix metalloproteinase (MMP)-3. In addition, L. obtusiloba reduced gelatinolytic activity of HSC by interfering with profibrogenic MMP-2 activity. Since L. obtusiloba extract prevented intracellular oxidative stress experimentally induced by tert-butylhydroperoxide, we concluded that the direct antifibrotic effect of L. obtusiloba extract might be mediated by antioxidant activity. Thus, L. obtusiloba, traditionally used in Oriental medicine, may complement treatment of chronic liver disease.
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Affiliation(s)
- Martin Ruehl
- Department of Gastroenterology, Charité - Campus Benjamin Franklin, 12200 Berlin, Germany
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Chen FP, Kung YY, Chen YC, Jong MS, Chen TJ, Chen FJ, Hwang SJ. Frequency and pattern of Chinese herbal medicine prescriptions for chronic hepatitis in Taiwan. JOURNAL OF ETHNOPHARMACOLOGY 2008; 117:84-91. [PMID: 18321671 DOI: 10.1016/j.jep.2008.01.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2007] [Revised: 10/27/2007] [Accepted: 01/19/2008] [Indexed: 05/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Chinese herbal medicine (CHM) has been commonly used in treating liver diseases in Asian countries. AIM OF STUDY To conduct a large-scale pharmacoepidemiological study and evaluate the frequency and pattern of CHM prescriptions in treating chronic hepatitis. MATERIALS AND METHODS We obtained the database of traditional Chinese medicine outpatient claims from the national health insurance in Taiwan for the whole 2002. Patients with chronic hepatitis were identified by the corresponding diagnosis of International Classification of Disease among claimed visiting files. Corresponding prescription files were analyzed, and association rule were applied to evaluate the co-prescription of CHM in treating chronic hepatitis. RESULTS Among the 91,080 subjects treated by CHM for chronic hepatitis, the peak age was in the 40 s, followed by 30 s and 50 s. Male/female ratio was 2.07:1. Long-dan-xie-gan-tang and Saliva miltiorrhiza (Dan-shen) were the most commonly prescribed Chinese herbal formula and single herbal drug, respectively. The most common two-drug prescription was Jia-wei-xia-yao-san plus Saliva miltiorrhiza, and the most common three-drug prescription was Jia-wei-xia-yao-san plus Saliva miltiorrhiza and Artemisia capillaries (Yin-chen-hao). CONCLUSIONS This study showed the utilization pattern of Chinese herbal drugs or formulae in treating chronic hepatitis. Further researches and clinical trials are needed to evaluate the efficacy of these Chinese herbs or its ingredients in treating chronic hepatitis.
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Affiliation(s)
- Fang-Pey Chen
- Center for Traditional Medicine, Taipei Veterans General Hospital, National Yang-Ming University School of Medicine, Taipei, Taiwan
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Inhibitory effects of some derivatives of glycyrrhizic acid against Epstein-Barr virus infection: structure-activity relationships. Antiviral Res 2008; 79:6-11. [PMID: 18423902 PMCID: PMC7114209 DOI: 10.1016/j.antiviral.2008.01.160] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2007] [Revised: 01/08/2008] [Accepted: 01/31/2008] [Indexed: 01/18/2023]
Abstract
Glycyrrhizic acid (18β-GL or GL) is a herbal drug with a broad spectrum of antiviral activities and pharmacological effects and multiple sites of action. Previously we showed that GL inhibits Epstein-Barr virus (EBV) infection in vitro by interfering with an early step of the EBV replication cycle (possibly attachment/penetration). Here we tested the effects of 15 GL derivatives against EBV infection by scoring the numbers of cell expressing viral antigens and quantifying EBV DNA copy numbers in superinfected Raji cells. The derivatives were made either by transformation of GL on carboxyl and hydroxyl groups or by conjugation of amino acid residues into the carbohydrate part. We identified seven compounds active against EBV and all showed dose-dependent inhibition as determined by both assays. Among these active compounds, the introduction of amino acid residues into the GL carbohydrate part enhanced the antiviral activity in three of the seven active compounds. However, when Glu(OH)-OMe was substituted by Glu(OMe)-OMe, its antiviral activity was completely abolished. Introduction of potassium or ammonium salt to GL reduced the antiviral activity with no significant effect on cytotoxicity. The α-isomer (18α-GL) of 18β-GL was as potent as the β-form, but its sodium salt lost antiviral activity. The metabolic product of GL, 18β-glycyrrhetinic acid (18β-GA or GA), was 7.5-fold more active against EBV than its parental compound GL but, concomitantly, exhibited increased cytotoxicity resulting in a decreased therapeutic index.
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Yip PY, Chau CF, Mak CY, Kwan HS. DNA methods for identification of Chinese medicinal materials. Chin Med 2007; 2:9. [PMID: 17803808 PMCID: PMC2042497 DOI: 10.1186/1749-8546-2-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2006] [Accepted: 09/05/2007] [Indexed: 11/10/2022] Open
Abstract
As adulterated and substituted Chinese medicinal materials are common in the market, therapeutic effectiveness of such materials cannot be guaranteed. Identification at species-, strain- and locality-levels, therefore, is required for quality assurance/control of Chinese medicine. This review provides an informative introduction to DNA methods for authentication of Chinese medicinal materials. Technical features and examples of the methods based on sequencing, hybridization and polymerase chain reaction (PCR) are described and their suitability for different identification objectives is discussed.
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Affiliation(s)
- Pui Ying Yip
- Department of Biology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chi Fai Chau
- Department of Food Science and Biotechnology, National Chung Hsing University, 250 Kuokuang Road, Taichung 40227, Taiwan
| | - Chun Yin Mak
- Department of Biology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Hoi Shan Kwan
- Department of Biology, The Chinese University of Hong Kong, Shatin, Hong Kong
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32
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White CP, Hirsch G, Patel S, Adams F, Peltekian KM. Complementary and alternative medicine use by patients chronically infected with hepatitis C virus. CANADIAN JOURNAL OF GASTROENTEROLOGY = JOURNAL CANADIEN DE GASTROENTEROLOGIE 2007; 21:589-95. [PMID: 17853954 PMCID: PMC2657989 DOI: 10.1155/2007/231636] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2006] [Accepted: 01/26/2007] [Indexed: 11/18/2022]
Abstract
Complementary and alternative medicine (CAM) is becoming increasingly popular in North America. The use of CAM is also popular in patients with chronic liver disease but is not well documented. The extent of use of CAM in chronic hepatitis C virus (HCV) infected patients was determined, and the demographic and clinical data between users and nonusers of CAM was compared. Seventy-six patients (30% female) with chronic HCV were interviewed. The mean age was 43+/-8 years. Current use of CAM for HCV was reported by 35 of 76 patients (46%). Eighteen of 76 patients within this group used herbal supplements (24%). The most commonly used herb was Silybum marianum (milk thistle), reported by 10 of 76 patients (13.2%). Commonly reported benefits of CAM use included reduction in fatigue, boost in the immune system and improved gastrointestinal function. No adverse effects of CAM use were reported. In the present study, four of 18 patients (22%) with chronic liver disease taking herbal therapies were on herbs that increased bleeding time. The use of CAM in chronic HCV patients is significant. Patients should be asked specifically about their use of CAM. CAM use may have implications affecting conventional treatment and management of HCV.
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Affiliation(s)
- Colin P White
- Hepatology Services, Division of Gastroenterology, Departments of Medicine, Dalhousie University and the Capital District Health Authority, Halifax, Nova Scotia
| | - Gerilynn Hirsch
- Hepatology Services, Division of Gastroenterology, Departments of Medicine, Dalhousie University and the Capital District Health Authority, Halifax, Nova Scotia
| | - Sunil Patel
- Hepatology Services, Division of Gastroenterology, Departments of Medicine, Dalhousie University and the Capital District Health Authority, Halifax, Nova Scotia
| | - Fatin Adams
- Rockyview General Hospital, Calgary, Alberta
| | - Kevork M Peltekian
- Hepatology Services, Division of Gastroenterology, Departments of Medicine, Dalhousie University and the Capital District Health Authority, Halifax, Nova Scotia
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Morinaga S, Tarao K, Yamamoto Y, Nakamura Y, Rino Y, Miyakawa K, Ohkawa S, Akaike M, Sugimasa Y, Takemiya S. Overexpressed cyclo-oxygenase-2 in the background liver is associated with the clinical course of hepatitis C virus-related cirrhosis patients after curative surgery for hepatocellular carcinoma. J Gastroenterol Hepatol 2007; 22:1249-55. [PMID: 17688665 DOI: 10.1111/j.1440-1746.2006.04367.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The probable role of cyclo-oxygenase-2 (COX-2) in the development of hepatocellular carcinoma (HCC) in patients with chronic liver diseases has been accepted to be relevant. The purpose of the present study was to determine whether overexpressed COX-2 in the background liver affects the clinical course of hepatitis C virus (HCV)-related cirrhosis patients after curative surgery for HCC. METHODS Twenty-nine clinical stage I HCC patients with HCV-related cirrhosis, who underwent curative surgery, were enrolled in the present study (22 men and seven women, age range 53-73 years; follow-up period; range 22-159 months, median 61 months). The COX-2 expression in the cirrhotic liver was examined by immunohistochemistry using the avidin-biotin-peroxidase complex technique on paraffin-embedded formalin-fixed tissue. The COX-2 expression was scored, then correlated with monitored alanine aminotransferase (ALT) levels during the follow-up period after surgery, response to alternative therapy aiming to improve elevated ALT levels, and recurrence/survival after surgery. RESULTS The COX-2 expression scores were significantly higher in the high-ALT group than in the low-ALT group (Mann-Whitney, P = 0.010), and were significantly higher in non-responders to the alternative therapy than in responders (Mann-Whitney, P = 0.028). The higher COX-2 expression in the cirrhotic liver was the significant independent risk factor for residual liver recurrence (Cox multivariate analysis, P = 0.014), but not for survival. CONCLUSIONS Overexpressed COX-2 in the background liver may play an important role in prolonged acceleration of necroinflammation, resistance to the alternative therapy, and recurrence/new development of HCC in HCV-related cirrhosis patients.
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Affiliation(s)
- Soichiro Morinaga
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Asahikum, Japan.
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Han J, Sun M, Cui Y, Wang T, Zhang W, Guo M, Zhou Y, Liu W, Zhang M, Duan J, Xiong S, Yao M, Yan X. Kushen flavonoids induce apoptosis in tumor cells by inhibition of NF-kappaB activation and multiple receptor tyrosine kinase activities. Phytother Res 2007; 21:262-8. [PMID: 17186493 DOI: 10.1002/ptr.2065] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In this report, the mechanism of the antitumor activities of Kushen flavonoids (KS-Fs) were explored. KS-Fs and kurarinone (Kur), a single flavonoid compound, were able to induce apoptosis of H460 and Eca-109 cells in vitro and H460 cells in vivo. The apoptosis inducing effect was enhanced in the presence of Taxol. In H460 xenograft mice treated with Kur, down-regulation of Bcl-2 and up-regulation of caspase 8 and caspase 3 in tumors were observed by immunohistochemical staining. In addition, KS-Fs and Kur were able to inhibit TNFalpha-induced NF-kappaB activation in 293 cells mediated by the decreased IkappaBalpha phosphorylation. Further the effects of KS-Fs and Kur on multiple receptor tyrosine kinase activities were explored. In cell-based assays, KS-Fs and Kur inhibited the EGF-induced EGF receptor phosphorylation in A431 cells and a constitutively activated Her-2 in MDA-MB-453s cells. In enzymatic assays, KS-Fs and Kur inhibited KDR, but not PDGF BR activities. In A431 xenograft mice treated with Kur, an inhibition of EGF receptor phosphorylation in tumors was observed. These results reveal a novel mechanism by which KS-Fs induces apoptosis in tumors by acting on multiple cellular targets including the inhibition of NF-kappaB activation and multiple receptor tyrosine kinase activities.
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MESH Headings
- Animals
- Antineoplastic Agents, Phytogenic/administration & dosage
- Antineoplastic Agents, Phytogenic/pharmacology
- Antineoplastic Agents, Phytogenic/therapeutic use
- Apoptosis/drug effects
- Cell Line, Tumor/drug effects
- Cell Line, Tumor/metabolism
- Drugs, Chinese Herbal/administration & dosage
- Drugs, Chinese Herbal/pharmacology
- Drugs, Chinese Herbal/therapeutic use
- Flavonoids/administration & dosage
- Flavonoids/pharmacology
- Flavonoids/therapeutic use
- Humans
- Mice
- Mice, Inbred BALB C
- NF-kappa B/metabolism
- Phytotherapy
- Receptor Protein-Tyrosine Kinases/metabolism
- Transplantation, Heterologous
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Affiliation(s)
- Jun Han
- Department of Biology, Hutchison Medipharma Ltd., Zhang Jiang Hi-Tech Park, Shanghai 201203, China
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Complementary and alternative Medicine (CAM) for the Treatment of Chronic Hepatitis B and C: A Review. Antivir Ther 2007. [DOI: 10.1177/135965350701200316] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Complementary and alternative medicine (CAM) has been used for centuries in China and Japan to treat various illnesses, including viral hepatitis. Several therapeutic approaches constitute CAM, the most relevant for this review being the use of herbals. However, profound disagreements exist between conventional and alternative medicine practitioners regarding their value. Western medical advocates cite deep concerns about the purity of most herbals because of lack of standardized production, the paucity of pharmacokinetic data, the fact that few well-designed randomized, controlled trials of these products have been performed and the evidence that some herbals have been responsible for severe adverse effects. Nevertheless, many in the public, even in western countries, turn to the use of herbals, believing that they must be safe and effective because they are ‘natural’ and have been used for centuries, and because of dissatisfaction with conventional medicine. Accordingly, their use in western countries and the costs incurred have increased each year. While there is evidence that some herbals have physiological effects, there still is insufficient evidence to recommend their use. This paper reviews the classification, epidemiology and philosophy of CAM, and the reasons advanced for herbal use to treat viral hepatitis. The criteria necessary to develop a potential pharmacological agent are presented, as well as the requirements for conducting a scientifically valid treatment trial of herbals. Five herbals used in the past to treat viral hepatitis are reviewed and evaluated for the quality of their studies and mention is made of herbals known to have adverse effects.
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Stickel F, Schuppan D. Herbal medicine in the treatment of liver diseases. Dig Liver Dis 2007; 39:293-304. [PMID: 17331820 DOI: 10.1016/j.dld.2006.11.004] [Citation(s) in RCA: 210] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Revised: 10/02/2006] [Accepted: 11/06/2006] [Indexed: 12/11/2022]
Abstract
Herbal drugs have become increasingly popular and their use is widespread. Licensing regulations and pharmacovigilance regarding herbal products are still incomplete and clearcut proof of their efficacy in liver diseases is sparse. Nevertheless, a number of herbals show promising activity including silymarin for antifibrotic treatment, phyllantus amarus in chronic hepatitis B, glycyrrhizin to treat chronic viral hepatitis, and a number of herbal combinations from China and Japan that deserve testing in appropriate studies. Apart from therapeutic properties, reports are accumulating about liver injury after the intake of herbals, including those advertised for liver diseases. Acute and/or chronic liver damage occurred after ingestion of some Chinese herbs, herbals that contain pyrrolizidine alkaloids, germander, greater celandine, kava, atractylis gummifera, callilepsis laureola, senna alkaloids, chaparral and many others. Since the evidence supporting the use of botanicals to treat chronic liver diseases is insufficient and only few of them are well standardised and free of potential serious side effects, most of these medications are not recommended outside clinical trials. Particularly with regard to the latter, adequately powered randomised-controlled clinical trials with well-selected end points are needed to assess the role of herbal therapy for liver diseases.
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Affiliation(s)
- F Stickel
- Institute of Clinical Pharmacology, University of Berne, Murtenstrasse 35, CH-3010 Berne, Switzerland.
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Vilar Gomez E, Gra Oramas B, Soler E, Llanio Navarro R, Ruenes Domech C. Viusid, a nutritional supplement, in combination with interferon alpha-2b and ribavirin in patients with chronic hepatitis C. Liver Int 2007; 27:247-59. [PMID: 17311621 DOI: 10.1111/j.1478-3231.2006.01411.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
BACKGROUND The pathogenesis of chronic hepatitis C (CHC) is associated to severe oxidative stress that leads to necro-inflammation and progression of fibrosis. Previous trials suggested that antioxidative therapy may have a beneficial effect. We evaluated the efficacy and safety of Viusid in combination with interferon alpha-2b (IFN alpha-2b) and ribavirin in patients with CHC. METHODS We randomly assigned 100 patients, between October 2002 and December 2004, in two arms: IFN alpha-2b (5 MU on alternate days), ribavirin at a dose of 13 mg/kg daily and Viusid (three sachets daily) vs. IFN alpha-2b (5 MU on alternate days) and ribavirin at a dose of 13 mg/kg daily. Subjects were treated for 48 weeks and then followed for an additional 24 weeks. The primary end point was the histologic response (reduction of at least two points without fibrosis worsening in the total score on the Histological Activity Index). RESULTS A significantly high proportion of patients who received combined therapy plus Viusid had a histologic response better than those patients who received IFN alpha-2b and ribavirin (57% vs. 37%, P=0.03). The patients with virologic response achieved the highest percentages of histologic response, irrespective of assigned treatment. Among non-responders, the highest reduction in the mean change from baseline score for necro-inflammatory activity (NA) and fibrosis (F) was reported in patients treated with Viusid [NA, -1.50 (Viusid), -1.20 (without Viusid); F, -0.31 (Viusid), 0.00 (without Viusid)]. Sustained normalization of serum alanine aminotransferase concentration was highest in the Viusid group compared with standard therapy (67% vs. 41%, P=0.009). The overall safety profile was similar in both groups, but interestingly, the anemia was less intense in the group with Viusid (P=0.04). CONCLUSIONS Our results suggest that triple therapy with Viusid, IFN alpha-2b and ribavirin was well tolerated and may have a beneficial effect on histologic and biochemical variables. The intensity of anemia is reduced in patients treated with Viusid.
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Affiliation(s)
- Eduardo Vilar Gomez
- Department of Hepatology, National Institute of Gastroenterology, Havana, Cuba.
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Alexander J, Tung BY, Croghan A, Kowdley KV. Effect of iron depletion on serum markers of fibrogenesis, oxidative stress and serum liver enzymes in chronic hepatitis C: results of a pilot study. Liver Int 2007; 27:268-73. [PMID: 17311623 DOI: 10.1111/j.1478-3231.2007.01449.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
BACKGROUND Hepatic iron deposition has been associated with decreased response to interferon-alpha monotherapy, and has been speculated to contribute to disease progression in chronic hepatitis C (CHC). We performed this study to evaluate the effect of iron depletion on biochemical and virologic markers, and markers of lipid peroxidation and fibrogenesis. MATERIALS AND METHODS Eighteen patients with CHC who did not have a virologic response to interferon monotherapy underwent weekly phlebotomies until iron depletion (serum ferritin <50 ng/ml). Serum levels of alanine transaminase (ALT), hepatitis C virus-RNA, transferrin saturation, ferritin, 8-isoprostane, hyaluronic acid, amino-terminal procollagen III peptide and YKL-40 were measured before and after iron depletion. RESULTS There was a statistically significant reduction of serum ALT, transferrin saturation and serum ferritin after iron depletion (range 4-11 phlebotomies). Serum ALT returned to normal after iron depletion in four (22%) patients. There was a significant reduction in serum procollagen III peptide level among patients who achieved biochemical response. No significant reduction was noted in serum levels of other markers. CONCLUSIONS Iron depletion was associated with a biochemical response in 22% of patients who did not respond to interferon monotherapy. There was a significant reduction in a key marker of fibrogenesis among patients with biochemical response. These data support longer-term studies of iron depletion in CHC.
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Affiliation(s)
- Jacob Alexander
- Department of Medicine, Division of Gastroenterology, University of Washington Medical Center, Seattle, WA, USA
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Cherng JM, Lin HJ, Hung MS, Lin YR, Chan MH, Lin JC. Inhibition of nuclear factor κB is associated with neuroprotective effects of glycyrrhizic acid on glutamate-induced excitotoxicity in primary neurons. Eur J Pharmacol 2006; 547:10-21. [PMID: 16952351 DOI: 10.1016/j.ejphar.2006.06.080] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2006] [Revised: 06/26/2006] [Accepted: 06/27/2006] [Indexed: 01/04/2023]
Abstract
Glycyrrhizic acid is an herbal drug with a broad spectrum of antiviral activities and pharmacological effects and multiple sites of action. We investigated whether glycyrrhizic acid protects against glutamate-induced excitotoxicity and the underlying mechanisms. We found that glycyrrhizic acid protected against neurotoxicity in rat primary neuronal cultures and hippocampal slices by suppression of the glutamate-induced apoptosis. Glycyrrhizic acid conferred neuroprotective properties in a concentration-dependent manner, as determined by cell survival, apoptosis, and Ca(2+) influx. Glycyrrhizic acid selectively inhibited the Ca(2+) influx activated through N-methyl-D-aspartate (NMDA) receptor by glutamate, but not through membrane depolarization elicited by high K(+) induction. Glycyrrhizic acid treatment also diminished glutamate-induced DNA fragmentation and cleavage of poly (ADP-ribose) polymerase (PARP). Electrophoretic mobility shift assay (EMSA) indicated that glycyrrhizic acid inhibited the binding activity of nuclear factor kappaB (NF-kappaB) to its target elements. Western blot analysis of NF-kappaB inhibitor (IkappaBalpha) protein revealed that the inhibitory effect of glycyrrhizic acid on glutamate-induced activation of NF-kappaB activity was attributable to the inhibition of IkappaB kinase activity. Thus, the site of action of glycyrrhizic acid could be a downstream consequence of Ca(2+)entry through NMDA receptors and that NF-kappaB may be one downstream target in this process. These observations suggest that glycyrrhizic acid may be of therapeutic value for the prevention of cerebral damage elicited by the glutamate.
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Affiliation(s)
- Jaw-Ming Cherng
- Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan, ROC
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40
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Orlent H, Hansen BE, Willems M, Brouwer JT, Huber R, Kullak-Ublick GA, Gerken G, Zeuzem S, Nevens F, Tielemans WCM, Zondervan PE, Lagging M, Westin J, Schalm SW. Biochemical and histological effects of 26 weeks of glycyrrhizin treatment in chronic hepatitis C: a randomized phase II trial. J Hepatol 2006; 45:539-46. [PMID: 16905220 DOI: 10.1016/j.jhep.2006.05.015] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2006] [Revised: 05/16/2006] [Accepted: 05/17/2006] [Indexed: 02/07/2023]
Abstract
BACKGROUND/AIMS Phase I/II studies of 4 weeks duration have confirmed the ALT lowering effect of glycyrrhizin in Western chronic hepatitis C patients. Our aim was to determine the dose frequency of glycyrrhizin required to maintain the ALT response beyond 4 weeks and evaluate its effect on liver histology and quality of life. METHODS HCV-RNA-positive patients with elevated ALT and marked fibrosis or necro-inflammation who were not eligible for interferon therapy were treated for 4 weeks with six infusions weekly of glycyrrhizin. Patients with an ALT response at week 4 were randomized to continue treatment for 22 weeks in three dose frequency groups: 6x, 3x or once weekly. RESULTS 72/121 (60%) patients were randomized. At the end of treatment the ALT response was maintained in 60%, 24% and 9% of patients in the 6x, 3x, and once weekly groups, respectively (p<0.001). In ALT responders the necro-inflammation score improved non-significantly compared to ALT non-responders. Quality of life assessed by SF-36 increased in patients treated with the study drug, albeit unrelated to the occurrence of ALT response. CONCLUSIONS ALT responses induced by 4 weeks glycyrrhizin therapy can be maintained in a subset of chronic hepatitis C patients receiving at least three injections weekly. The observed ALT response did not translate in a significant histological improvement after 6 months treatment.
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Affiliation(s)
- Hans Orlent
- Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, The Netherlands
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Huang KL, Lai YK, Lin CC, Chang JM. Inhibition of hepatitis B virus production by Boehmeria nivea root extract in HepG2 2.2.15 cells. World J Gastroenterol 2006; 12:5721-5. [PMID: 17007029 PMCID: PMC4088177 DOI: 10.3748/wjg.v12.i35.5721] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To explore the anti-hepatitis B virus (HBV) effects of Boehmeria nivea (B. nivea) root extract (BNE) by using the HepG2 2.2.15 cell model system.
METHODS: Hepatitis B surface antigen (HBsAg), hepatitis B virus e antigen (HBeAg), and HBV DNA were measured by using ELISA and real-time PCR, respectively. Viral DNA replication and RNA expression were determined by using Southern and Northern blot, respectively.
RESULTS: In HepG2 2.2.15 cells, HBeAg (60%, P < 0.01) and particle-associated HBV DNA (> 99%, P < 0.01) secretion into supernatant were significantly inhibited by BNE at a dose of 100 mg/L, whereas the HBsAg was not inhibited. With different doses of BNE, the reduced HBeAg was correlated with the inhibition of HBV DNA. The anti-HBV effect of BNE was not caused by its cytotoxicity to cells or inhibition of viral DNA replication and RNA expression.
CONCLUSION: BNE could effectively reduce the HBV production and its anti-HBV machinery might differ from the nucleoside analogues.
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MESH Headings
- Antiviral Agents/pharmacology
- Boehmeria/chemistry
- Carcinoma, Hepatocellular/drug therapy
- Carcinoma, Hepatocellular/metabolism
- Carcinoma, Hepatocellular/pathology
- Carcinoma, Hepatocellular/virology
- Cell Line, Tumor
- Cytotoxins/pharmacology
- DNA Replication/drug effects
- DNA, Viral/genetics
- DNA, Viral/metabolism
- Gene Expression Regulation, Neoplastic/drug effects
- Gene Expression Regulation, Viral/drug effects
- Hepatitis B Surface Antigens/genetics
- Hepatitis B Surface Antigens/metabolism
- Hepatitis B e Antigens/genetics
- Hepatitis B e Antigens/metabolism
- Hepatitis B virus/drug effects
- Hepatitis B virus/genetics
- Hepatitis B virus/immunology
- Hepatitis B virus/metabolism
- Humans
- Liver Neoplasms/drug therapy
- Liver Neoplasms/metabolism
- Liver Neoplasms/pathology
- Liver Neoplasms/virology
- Plant Extracts/analysis
- Plant Extracts/pharmacology
- Plant Extracts/therapeutic use
- Plant Roots/chemistry
- RNA, Viral/genetics
- RNA, Viral/metabolism
- Transcription, Genetic/drug effects
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Affiliation(s)
- Kai-Ling Huang
- Division of Research and Development, Development Center for Biotechnology, Xizhi City, Taipei County, Taiwan 221, China
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Donabedian H. Nutritional therapy and infectious diseases: a two-edged sword. Nutr J 2006; 5:21. [PMID: 16952310 PMCID: PMC1570358 DOI: 10.1186/1475-2891-5-21] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2006] [Accepted: 09/04/2006] [Indexed: 01/03/2023] Open
Abstract
The benefits and risks of nutritional therapies in the prevention and management of infectious diseases in the developed world are reviewed. There is strong evidence that early enteral feeding of patients prevents infections in a variety of traumatic and surgical illnesses. There is, however, little support for similar early feeding in medical illnesses. Parenteral nutrition increases the risk of infection when compared to enteral feeding or delayed nutrition. The use of gastric feedings appears to be as safe and effective as small bowel feedings. Dietary supplementation with glutamine appears to lower the risk of post-surgical infections and the ingestion of cranberry products has value in preventing urinary tract infections in women.
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Affiliation(s)
- Haig Donabedian
- Professor of Medicine, College of Medicine, University of Toledo, 3120 Glendale Avenue, Toledo, OH 43614, USA.
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Song G, Luo Q, Qin J, Wang L, Shi Y, Sun C. Effects of oxymatrine on proliferation and apoptosis in human hepatoma cells. Colloids Surf B Biointerfaces 2006; 48:1-5. [PMID: 16458489 DOI: 10.1016/j.colsurfb.2005.12.012] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2005] [Revised: 12/10/2005] [Accepted: 12/24/2005] [Indexed: 01/29/2023]
Abstract
Oxymatrine, a natural quinolizidine alkaloid, has been known having cytotoxic and chemopreventive effects on various cancer cells. To investigate the possible mechanism of oxymatrine's role on cancer cells, in the present study, we examined further the effects of oxymatrine on the growth, proliferation, apoptosis and expression of bcl-2 and p53 gene in human hepatoma SMMC-7721 cells in vitro. Our results show that oxymatrine notably inhibits the growth and proliferation of SMMC-7721 cells and it present a dose-dependence and time-dependence manner within definite reacting dose and time. Oxymatrine block SMMC-7721 cells in G2/M and S phase; prevent cells entering into G0/G1 phase. It results in an obvious accumulation of G2/M and S phase cells while decrease of G0/G1 phase cells. Oxymatrine induce apoptosis of SMMC-7721 cells and apoptotic rate amount to about 60% after treatment with 1.0 mg/ml oxymatrine for 48 h. We also find that oxymatrine down-regulate expression of bcl-2 gene while up-regulate expression of p53 gene. These results demonstrate that oxymatrine inhibit the proliferation and induce apoptosis of human hepatoma SMMC-7721 cells, and suggest that this effect was mediated probably by a significant cell cycle blockage in G2/M and S phase, down-regulation of bcl-2 and up-regulation of p53.
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Affiliation(s)
- Guanbin Song
- College of Bioengineering, Chongqing University, Key Laboratory of Biomechanics and Tissue Engineering, State Ministry of Education, Chongqing 400044, PR China.
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Giannini EG, Romagnoli P, Testa R. Eligibility criteria for antiviral therapy in HCV-positive patients: similar things to (almost) similar people. Am J Gastroenterol 2006; 101:406-7. [PMID: 16454854 DOI: 10.1111/j.1572-0241.2006.00401_6.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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45
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Dienstag JL, McHutchison JG. American Gastroenterological Association technical review on the management of hepatitis C. Gastroenterology 2006; 130:231-64; quiz 214-7. [PMID: 16401486 DOI: 10.1053/j.gastro.2005.11.010] [Citation(s) in RCA: 267] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Jules L Dienstag
- Gastrointestinal Unit (Medical Services) Massachusetts General Hospital, Department of Medicine and Office of the Dean for Medical Education, Harvard Medical School, Boston, Massachusetts, USA
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Zhu K, Fukasawa I, Furuno M, Inaba F, Yamazaki T, Kamemori T, Kousaka N, Ota Y, Hayashi M, Maehama T, Inaba N. Inhibitory effects of herbal drugs on the growth of human ovarian cancer cell lines through the induction of apoptosis. Gynecol Oncol 2005; 97:405-9. [PMID: 15863137 DOI: 10.1016/j.ygyno.2004.12.063] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2004] [Revised: 12/27/2004] [Accepted: 12/30/2004] [Indexed: 10/25/2022]
Abstract
OBJECTIVE In order to develop and search for more effective and safe treatments for early and advanced stages of ovarian cancer, we examined the direct effects of four extracts of Chinese herbal drugs on ovarian cancer cells in vitro. METHODS The growth inhibition of four herbal drugs on a total of six cell lines of human ovarian cancer cells was determined by a Cell Counting Kit-8 by counting viable cells. Apoptotic cells induced by herbal drugs were detected by using MEBCYTO Apoptosis Kit. All experiments were performed in triplicate. The significance of the difference was analyzed with a two-sided Student's t test. A P value less than 0.05 was accepted as statistically significant. RESULTS The MN, A2780, and KF cell lines exhibited significant growth inhibition in the presence of Sho-saiko-to concentrations of 150 microg/ml, 300 microg/ml, and 500 microg/ml, respectively, and at the concentration of 1000 microg/ml, Sho-saiko-to demonstrated a significant apoptotic induction effect on all six kinds of ovarian cancer cell lines. This concentration is the same as the blood concentration attained when 7.5 g of Sho-saiko-to per day is orally administered and all absorbed. CONCLUSIONS Sho-saiko-to exhibited significant growth inhibition of ovarian cancer cell lines, and the mechanisms of the inhibitory effects can be attributed, in part, to apoptosis induced by Sho-saiko-to.
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Affiliation(s)
- Kun Zhu
- Department of Obstetrics and Gynecology, Dokkyo University School of Medicine, 880 kita-Kobayashi, Mibu, Shimotsuga, 321-0293 Tochigi, Japan.
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Batey RG, Salmond SJ, Bensoussan A. Complementary and alternative medicine in the treatment of chronic liver disease. Curr Gastroenterol Rep 2005; 7:63-70. [PMID: 15701301 DOI: 10.1007/s11894-005-0068-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Interest in and use of complementary and alternative medicines (CAM) in the treatment of chronic liver diseases has increased in the past decade. However, this has not been supported by a significant increase in sound clinical research evidence for their efficacy. The research literature is growing, providing improved knowledge on population use of CAM, possible mechanisms of action of a large range of complementary and alternative medications, and possible specific indications for these agents in patients with liver disease. Although curative potential for CAM has not been documented consistently in any liver disorder, it is possible to identify anti-inflammatory activity and cytoprotective capacity for a number of agents from different branches of the world of CAM. Evidence grows for potential harm from an increasing number of compounds. Concurrently, clarity is increasing in relation to which specific constituents cause the harm and the mechanisms by which damage is produced.
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Affiliation(s)
- Robert G Batey
- Faculty of Health, University of Newcastle, Australia, PO Box 119, Wallsend NSW 2287, Australia.
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Abstract
The number one choice for treatment of chronic hepatitis C is the combination of once weekly subcutaneous pegylated interferon plus daily oral ribavirin. The duration of treatment and dose of ribavirin must be tailored to the hepatitis C virus (HCV) genotype. Patients infected with HCV genotype 1 should be treated for 48 weeks with a standard dosage of ribavirin (1000 or 1200 mg/d). This ribavirin dosage regimen is 'off-label' when used in conjunction with pegylated interferon alfa-2b (12 kD). The approved dosage for use in combination with this agent is 800 mg daily. The appropriate duration of treatment and dosage of ribavirin for patients infected with HCV genotype 2 or 3 differs depending on the pegylated interferon that is chosen. It is important to note that the treatment paradigm for these individuals is quickly evolving. When using peginterferon alfa-2a (40 kD) in patients with HCV genotype 2 or 3, the duration of treatment should be 24 weeks in combination with a low dose of ribavirin (800 mg/d). When using pegylated interferon alfa-2b (12 kD) in patients infected with HCV genotype 2 or in patients infected with genotype 3 and hepatitis C virus RNA less than 600,000 IU/mL, the duration of treatment should be 24 weeks. However, recent data suggest such treatment may not be optimal for patients infected with HCV genotype 3 and hepatitis C virus RNA at levels greater than or equal to 600,000 IU/mL; treatment duration may need to be greater than 24 weeks. When using pegylated interferon alfa-2b (12 kD) in patients infected with HCV genotype 3 and high viral load, the optimal dosage of ribavirin appears to be 800 to 1400 mg/d based on bodyweight.
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Bensoussan A, Lewith GT. Complementary medicine research in Australia: a strategy for the future. Med J Aust 2004; 181:331-3. [PMID: 15377248 DOI: 10.5694/j.1326-5377.2004.tb06303.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2004] [Accepted: 04/08/2004] [Indexed: 11/17/2022]
Abstract
Research funding for CAM is inadequate, resulting in too few good quality studies to support its use. Widespread use of CAM, as well as its media promotion, make this a vital public health issue, and the Australian government has a social and ethical obligation to respond by developing a research infrastructure (as has been done by the United Kingdom and United States governments). We propose a funding model that neither draws directly from the CAM industry nor from current health research budgets, yet would strengthen Australia's international role in CAM research. Establishing and applying focused research methods in CAM is imperative for strengthening its evidence base and creating fresh options for safe and effective patient care.
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Affiliation(s)
- Alan Bensoussan
- Centre for Complementary Medicine Research, University of Western Sydney, Locked Bag 1797, Penrith South DC, Sydney, NSW 1797, Australia.
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